A Look at Minimally Invasive Spine Surgery

​Minimally invasive spine surgery (MISS) has transformed the spinal care field by offering safer, faster, and precise alternatives to traditional surgery. It involves small incisions and the use of advanced imaging systems, tubular retractors, and specialized instruments, enabling surgeons to treat spinal conditions without the need for extensive muscle or tissue removal. MISS is commonly used to address herniated discs, spinal stenosis, scoliosis, and degenerative disc disease.

MISS is beneficial since it reduces tissue trauma. This procedure does not rely on large incisions and excessive muscle dissection, significantly minimizing blood loss, postoperative pain, and the risk of infection. Experts explain that muscle preservation, a primary principle of MISS, improves long-term spinal function, enhancing patients’ health and well-being.

MISS often allows for significantly shorter hospital stays, with some patients discharged the same day. This reduction in inpatient time helps lower healthcare costs and enables patients to return to their normal routines more quickly. Recovery times are also shorter than with traditional open surgery, especially when supported by targeted physical therapy.

There is also a lower risk of complications after having a MISS compared to the open approach. Instances of infections, blood clots, and adjacent tissue damage are rare, which is particularly beneficial for older patients and those with chronic conditions.

Once a surgeon determines that MISS is appropriate, they schedule a consultation to guide the patient on preparation. This typically includes a physical exam and imaging tests such as an MRI or X-ray, as well as a review of current medications. Patients who smoke are advised to quit, as nicotine can impair healing. Engaging in regular physical activity before surgery helps condition the muscles and may shorten recovery time. Surgeons also recommend arranging for someone to assist with transportation and provide support during the early recovery phase.

On the day of the surgery, an anesthesiologist administers anesthesia to manage the pain. The surgeon, depending on the type of MISS required, recommends either a local anesthesia that only numbs the target area and keeps the patient awake or general anesthesia that puts the patient to sleep throughout the surgery. The surgeon proceeds to make one or multiple incisions on the back or abdomen and inserts an endoscope, a slender tube with a camera at the end, to feed the monitor with footage of the operating area. The expert then fits small surgical equipment through the other incisions and carries out the procedure.

Notably, a healthcare provider is usually present in the operating room to monitor the patient’s vital signs, including heart rate and blood pressure, as the surgery proceeds. After successfully fixing the spinal issue, the surgeon removes the camera and operating equipment to allow the tissue to regain its initial position. They stitch up the incision area and cover it with bandages, and they can administer antibiotics to minimize the risk of infection.

After the procedure, patients are taken to a recovery room as the anesthesia wears off. Depending on the type of MISS performed, they may be discharged the same day or stay for observation. Postoperative discomfort is common, especially with movement, and can be managed with prescribed painkillers and cold therapy. Light walking is encouraged to activate muscles and aid healing, but patients should avoid lifting heavy objects until fully recovered.

Constantine Toumbis

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